Appointment Request

Advance Eye Care Center - Appointment request

If you would like schedule an eye exam, you can either phone our office 306-586-7036 or fill out the form below. Our staff is ready to assist you.
All the fields followed by a * are mandatory. If we do not respond within 24 hours please contact us by phone at (306)-586-7036 or email at advanceeyecarecenter@hotmail.com as this means we did not receive your request.

Referred by

Title

First Name*

Last Name*

Phone ((###)###-####)*

Alternate phone number ((###)###-####)

Email*

Date of birth*

Age Range

Are you a contact lens wearer?*

Yes

No

Doctor

Preferred day*

Please note that one of our representative will contact you to confirm or to propose a more suitable date.

Hour*

Message/comments

Name

This field is for validation purposes and should be left unchanged.

Contact Info

3617B Pasqua StreetRegina, SK S4S 6W8

Phone: 306-586-7036

Fax: 306-584-2259

We provide professional fitting of all contact lenses from any manufacturer including all soft, RGP and specialty lenses. Our doctors will fit you with the contact lenses best suited to your eyes!